How to transfer medical images from mobile scanners to hospitals 24/7?

Oleg

Hello, Stefan!

Stefan

Good morning!

Oleg

Welcome to the Devico Breakfast Bar! We invite people in the industry to join us and talk about what's happening in their organization and industry in general. Could you please introduce yourself and tell us about your professional background?

Stefan

So, I'm Stefan Claesen. I am the Chief Executive of a company called Visbion Limited. And Visbion specializes in transferring medical images from difficult and remote places back to hospitals.

Oleg

Amazing. Tell us about the project you're currently working on and the problems it solves in a more detailed way.

Stefan

In today's medical world, whenever you grab images or medical scans, such as CT scans or MRI scans, they are then transmitted to hospital and reviewed by a specialist called a radiologist. Now, in today's world, there are fewer and fewer radiologists, and it's a very scarce resource. And also because of the Covid situation, patients are more and more scared to go into hospitals for fear of catching something new that they didn't have before. So there is a current trend to take the imaging out from the hospital into the community, so to take the scanners out of the hospitals and to the patient.

And so in a lot of countries, both the US and all across Europe, today you will see CT scanners, and MRI scanners, and breast screening units, and lung screening units out in the back of trucks, going into community, into supermarket, car parks, into leisure centers, and so on, and scanning patients for a whole day, and then packing up in the evening, and moving to the next location, and scanning the next day and so on. And of course, that's very convenient for the patient because they can do their shopping, they can go for their mammogram, for their screening mammogram, all in one go and it's done.

Lots and lots of advantages of this because actually what it means is that the uptake of screening is much greater, it's much more convenient for the patients, and that can prevent a more significant advance of disease later on in life.This is happening across Europe and the US, everywhere. Now, the challenge, of course, is that on those mobile trailers, if you do spot something, then you want it reporting and the patient recalling really quite as quickly as possible. So, there is a need to transfer those images from the mobile scanners back to the hospitals as quickly as possible. And the way that used to be done, believe it or not, is by transferring those images onto a DVD disc at the end of the day, and sticking them in a taxi, and couriering them to the hospital.

And the next morning, they used to take a printed patient appointment list and taxi that back to the trailer. Now, you can imagine this is madness in today's age. There are significant costs associated with couriering. There is significant patient data that goes across, you know, in taxis. This is just not a sensible approach. It's expensive. There are all sorts of information governance issues around that. And what if something happens to the taxi in the meantime en route, then, all that data is lost or delayed. So, what Visbion does is it effectively connects those mobile scanners back to the hospitals in a real-time, live digital connectivity.

And so we use technology very similar to 4G on your mobile phone, but it's not the same 4G Internet as you use on your phone, but it's similar technology, to connect the trailers back to the hospital and transfer those imaging, that's imaging data and the appointments in pretty much real time. So, you can see lots and lots of advantages to projects, right? We provide the cost savings, we secure the data, there is much greater turnaround, but actually it also gives much greater flexibility. So if a patient, doesn't turn up for an appointment or can't make an appointment in the old days, that appointment was lost.

That was a very expensive scanner set there doing nothing and the appointment was lost. What is now possible is that you can rebook appointments on the day. So, it already drives up the utilization of the scanner, as well as securing the data, and so on. That is in a nutshell what our company does. I can give you more details on why that is a particular challenge. It may seem like an easy problem to solve, but actually very, very difficult to solve. And we can talk about that in a little bit if you like. That is in a nutshell, the technology that Visbion provides, and we are the only provider doing this across Europe. We have particular expertise and technology in this space that makes it work.

Oleg

That sounds really promising. What initially sparked your interest in the healthcare industry and what keeps you motivated to work in this field?

Stefan

So, I mean, my personal background is I've actually never ever had a job interview. I did medical engineering at Imperial College in London, and founded a company off the back of that called Visbion, and have run that business ever since. So, it's a particular, it's kind of my baby if you like, and that's what keeps me motivated every day. But of course, in addition to that, the stuff we do makes a real difference to patient lives. The services we provide are 24/7. Some of these scanners operate in the middle of the night. And when there is a road traffic accident, they are 100% reliant on our services. That actually is a huge motivating factor, not just for myself, but actually all of our staff. There are real people at the end of this, real people depending on our services. And it really is a critical service to our patients.

Oleg

Okay. Okay. Got it. Looking ahead, are there any emerging trends or technologies in your field that you believe will have a significant impact on businesses in the near future?

Stefan

So, of course, lots of people are talking about different communication technologies that are emerging. Things like Starlink is a very big thing because it gives access to more remote areas. That's a technology we are looking at integrating. Again, it has some drawbacks. And 5G will allow us greater speeds. And, therefore, much more detailed and much greater data sets, imaging data sets, to be transferred. So again, those are technologies we're looking at. So yes, the main advantages or the main new trends in our industry are better compression technologies and new communication technologies, which are forever being integrated.

Oleg

Okay. How do you keep yourself up to date with the latest technology?

Stefan

I'm actually part of international body called the DICOM organization, which is Digital Image Communication in Medicine. And it is the completely independent organization that writes the standards in the digital medical imaging field. I'm a member of that organization as are most other imaging scanner companies, healthcare IT companies, and so on. And we all come together three times, four times a year discuss the latest trends and, of course, develop new standards to integrate that new technology.

Oleg

Okay. What do you perceive as the biggest challenge and obstacle that you currently face in development of solution for healthcare industry?

Stefan

This is quite fascinating. This is an area that sort of ebbs and flows over years. But right now we are back in the challenge where the scanners themselves are improving so much and the data sets are getting bigger and bigger, but the communication technology isn't keeping up. So, now we're back in the challenges of compression, as I've mentioned already, and getting the enormous data sets that are created in seconds back through to the hospital and the communication challenge around that. If you go back five years, it was exactly the opposite way around.

That day, the communication technology with the advent of 3G, 4G really was quite fast, and the scanners weren't picking up. But now it's sort of gone the other way around again. And we see this ebb and flow over time. Now we're in a communication bandwidth-constrained environment. I'm sure in five to ten years time it will be the opposite way around again when communication catches up and the scanners have to go through a next-generation development cycle.

Oleg

Under 'communication' you mean transferring data? Correct?

Stefan

Right, right. So, things like 4G, Internet connectivity, those kind of things.

Oleg

Could you please comment on the issues related to the scarcity of skilled professionals in the IT sector?

Stefan

So, this is one of our constant challenges. As we grow, of course, we need more and more support staff to support more and more deployments. And I've mentioned already that our service is 24/7 and people rely 100% on that. Now, that is a little bit, you know, we've taken the view that's a little bit of a mug's game because you can never keep up with the growth, you can never hire more and more people and keep up with that growth. So, one of the approaches we've taken to this is to develop more and more automation around support, around monitoring, and so on.

That has brought us a slightly different challenge, which is we now need expert IT technical staff to develop that monitoring as opposed to the day-to-day support of the solution. And that's where we've really struggled to find really good IT staff within that environment. And of course, let's be honest, Brexit hasn't helped in the UK. So in the UK particularly, the IT shortages are now greater than ever before. So, that's why we've started looking elsewhere.

Oleg

Okay. Okay. Got it. Can you please tell us a bit more about monitoring solutions that you develop?

Stefan

I mean the big monitoring solutions are really around the reliability of the scanning provision. And that just not goes only around the communication. Of course, we need a reliable Internet connection or a reliable connection back to the hospital, I should say. And the reality is that mobile signal strengths vary and drop out on a regular basis. So the ability to monitor the throughputs, the data throughputs, the uptimes and very quickly alert if there is an issue, that is absolutely critical to our business. However, it's more than that. We also provide monitoring for the environmental parameters on those trucks.

So, those scanners are very, very delicate pieces of equipment. They were designed to go into hospitals, into static rooms in hospitals, and basements and never move. And now we're putting them on trucks that drive over bumpy roads with huge temperature variations because keeping temperatures stable in those trucks is very difficult. They're not made for bumpy roads, as I mentioned, so vibrations are a nightmare. And, in some cases, they even contain big magnets, so you can't even put it on a truck that is made out of standard steel. You have to make them completely out of aluminium, and that just provides even more challenges.

We do a lot of environmental monitoring: the stability of the temperatures, ensuring that the air conditioning is fully working and is keeping within parameters, that the generators, the backup generators on those trucks are fully functional, that fuel is available in those backup generators, that the utility power is of the right specification. Once you start getting into the detail of operating one of these trucks, you start discovering all sorts of interesting challenges and problems that you don't expect in a standard hospital. I'll give you one funny anecdote. When people first started doing this, they discovered that a lot of the big supermarkets – we put these trailers in supermarket car parks – a lot of these supermarkets actually reduced the mains voltage.

From 240 or 220 volts down to 210 or 200, and that saves on their power bill because most of these large supermarkets have big lighting systems and freezer systems in them. Of course, the scanners don't operate at those volt levels. So actually, we then ended up having to put generators in place just to be able to put the scanners in the car parks. So actually, superficially think this is that easy: you just park a truck in a car park, block off six car parking spaces, off you go. The reality is very different. So for us to be able to monitor that all the specifications, the environmental specifications, are in spec for reliable scanning is really, really critical.

Oleg

This is one of the issues you wouldn't have expected here, probably.

Stefan

Correct. Correct. So, this is one of these what just happened type moments where you think you've got it all covered and then you start discovering all sorts of new stuff. So, yeah, and that's what keeps us motivated, right? When you're into a project like this, these are challenges you solve and you go workaround, and that keeps it interesting and fun.

Oleg

That's right. I would like to come back to the shortage of IT resources in the UK and how it affects you. What role do you think IT outsourcing play in solving these challenges?

Stefan

Interesting thing about this, of course, is, and again, with yourselves, we've had some interesting experiences. We needed a member of staff to help very quickly on the remote monitoring and the IT infrastructure due to some internal staff issues and shortages. So, we initially took somebody on at very short notice to cover a gap. The reality is that we have discovered that person has become so valuable to our organization that this is now a permanent role. And, what can I say? We are very, very happy that we've gone down this route and it actually gives the company maximum flexibility because the person was taken on at very short notice has become productive very, very quickly. He works as part of our team, and it's now a long-term role for us.

Oleg

Amazing! What are the benefits and drawbacks of outsourcing?

Stefan

Challenges are, of course, around the risk and uncertainty. Because if you go back three years, we all used to worry about remote working and the ability to communicate to keep people under control and deliver the project to your own specification. The reality is that companies have learned to work remotely, and nowadays it really doesn't matter where people are based with online tools such as Microsoft Teams and Teams chats. We are in communication as much as the person is at the desk next door. So that I don't think is a challenge anymore. The challenge is more around the flexibility of somebody coming on in three weeks is great, but they can also leave in three or four weeks. So, that is, of course, a constant concern. And you have to train up a person. You have to train up a person: they don't become instantly valuable and work with the team.

But that's no different to your own employees. So really for me, the only real risk is around people leaving that you become reliant on. In terms of benefits, the other big benefit that we've seen is, rather surprisingly I must admit, the cost of bringing somebody in is actually no different, if not even better than hiring your own employee with all the overheads, with all the IT provision, and with absolutely everything else that you need to take care of. The benefits, the performance, you know, all of those things that come with a standard employee we don't have to worry about. It's kind of an all-in-one. It's done and dusted, and we gain 100% useful person. It's fantastic from that point of view. So for a one-off fee that is actually no different to what we would be paying our own staff we have gained many more sort of hidden benefits around that, and that's worked really well for us.

Oleg

Great to hear. What were the specific reasons that led you to consider IT outsourcing?

Stefan

Really recruitment. Recruitment. So, we were looking around recruitment in the UK. I must admit we had the mindset of it must be somebody local that we can talk to because we need to train them up. So we were looking at people in the UK and we just couldn't find them. We simply could not find them after months, and months, and months, which is why we started looking at alternative solutions. And as a small business owner, you have to put your big boy pants on briefly and go, 'Well, actually, will this work? And we'll give it a go.' For me, the big decision point was this is a one-month commitment initially. We'll give it a go – we'll see if it works. And we had a really, really positive experience out of it. It's paid off and I would encourage everybody to give it a go at least with no minimal commitment and you may be very surprised.

Oleg

Okay. How do you measure the success of collaboration with IT outsourcing vendor?

Stefan

The fact the person is here and doing useful work. And I don't actually even know how long he's been here now. But 18 months in, he's still here, he's still doing great job. That success for me right now. I don't need anything more than that. When we've then subsequently looked at other roles, again, we've recruited quite quickly on other roles and we've had useful and good people in very quickly. So again, that is something I didn't have to do the recruitment – it was a very good person delivered to me. So again, the onboarding process very quick and easy. And the fact they're still here a long period afterwards speaks for itself.

Oleg

And finally, what advice would you give to other companies considering IT outsourcing?

Stefan

Well, I think I've already said it actually. When you are a small business, every pound and every penny counts. And taking on a new member of staff is a big step for a lot of small businesses. Even when you're 20, every person matters. So, there is a natural tendency for people to recruit locally people you can be in control of. And you might find that actually takes a while and isn't as successful and takes up a lot of time to do. I would suggest give the outsourcing a go. Do it with a mindset of a one-month commitment and you may be very pleasantly surprised how easy and how well it works. Yeah, we've been really, really happy with the process.

Oleg

Amazing. Stefan, thanks for your participation. It was really useful information about the industry, about the company, about our cooperation. I really appreciate your participation. And thanks for your time.

Stefan

Thank you for the opportunity.

Oleg

Have a lovely day!

Stefan

Thank you. Bye-bye.

Oleg

Bye-bye.